Anaemia

Tomorrow I get to learn about anaemia. Yay! I’m excited for this so I’m pre reading.

There are three classes of anaemia:

  1. Microcytic (cells are smaller)
  2. Macrocytic (cells are bigger)
  3. Normocytic (cells are normal size)

In microcytic anaemia, the MCV (mean cell volume) is <80, low. This makes sense because the cells are smaller so they take up less space.

You can probably guess that in macrocytic volume MCV is high, defined as >96. And normocytic has an MCV between 80 and 96.

Causes of microcytic anaemia:

  • Iron deficiency - by far away the most common cause of anaemia, and can be due to blood loss, insufficient dietary intake, decreased absorption or increased demands on the body.
  • Anaemia of chronic disease
  • Sideroblastic anaemia - anaemia that has ring sideroblasts in the bone marrow. It can be caused by a variety of things such as alcohol abuse, lead toxicity, RA, myeloid leukaemia and a whole bunch of things.
  • Thalassaemia (A for Africa and Asia, B for… mediterranean)

Causes of normocytic anaemia:

  • Acute blood loss
  • Renal disease
  • Haemolytic anaemias
  • Endocrine disease
  • Autoimmune rheumatic disease
  • Marrow infiltration

Macrocytic anaemia can be divided again into two groups:

  1. Megaloblastic - which is caused almost exclusively by vitamin B12 or folate deficiency.
  2. Non-megaloblastic/normoblastic - which can commonly be found in pregnancy and in newborns or also in those with alcohol excess, liver disease, reticulocytosis, hypothyroidism, aplastic anaemia, sideroblastic anaemia (wtf, fitting into two categories?! way to make my life hard!), cytotoxic drugs e.g. azathiprine (an immunosupressant) => basically macrocytic anaemia with normal levels of B12 and folate
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Hi. I am a 23 year old final year medic in the UK.

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